To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values-integrity, patient-centered, respect, accountability, and compassion - must guide what we do, as individuals and professionals, every day.
Under the general direction of the OP Coding Supervisor, the Home Care Coder is responsible to review Plans of Care and other medical documentation to assign and sequence ICD-10-CM diagnostic codes for home care services. Work may include, but is not limited to: application of appropriate coding practices, prioritizing assigned coding tasks to meet AR goals, resolving claim edits/rejections and/or denials and payment discrepancies due to coding related activities, handling individual coding workload, and collaborating with clinical and billing team members for missing and/or inaccurate information in order to code accurately.
Responsibilities: 1. Accurately assigns ICD-10-CM codes from the care plans, and other applicable documentation in accordance with official coding guidelines. 2. Maintains a minimum of 95% overall coding quality score in diagnostic coding. 3. Maintains the productivity expectations as defined by the department standard for home care services. 4. Works closely with clinical team members for corrections/updates/clarifications to either the 485/POC, or the OASIS. 5. Works in conjunction with billing to resolve rejections, denials, or payment variances related to the diagnostic code selections. 6. Works with peers and/or leadership to create and maintain accurate up-to-date policies and procedures. 7. Acts as the subject matter expert in home care coding and reimbursement for the department. 8. Serves as a mentor to other team members to share knowledge, training, and education on home care coding. 9. Exhibits enthusiasm for the profession, embraces educational opportunities and department support offered and remains engaged in the goals and vision of the department.
Bachelors degree preferred. Requires course work, preferably college level, in anatomy and physiology, medical terminology, pathophysiology, and disease process.
Requires a minimum of 2 years' experience, with at least one year coding/OASIS within a home care agency. HCS-D is required. OASIS-D certification preferred.
HCS-D is required offered by the Board of Medical Specialty Coding & Compliance (BMSC).
Comprehensive knowledge of anatomy/physiology, medical terminology, and ICD-10 diagnostic code application in a home care setting. Requires a comprehensive understanding of Patient Driven Grouping Models (PDGM) to be implemented in 2020 and impact coding has on payment methodology. Must possess excellent communications skills orally and in writing, strong critical thinking and reasoning skills, in addition to time management skills. Must be able to perform functions independently and under limited supervision. Must be able to leverage technology. The ability to mentor and/or train fellow team members is needed.
Must meet the defined accuracy and productivity standards. Must be able to manage individual workload, and follow all coding workflows in place. Adheres to Yale New Haven Health Standards of Professional Behavior: Patient-Centered Care, Respect, Compassion, Integrity, and Accountability.
COMPLEXITY: Exercises independent judgment in determining appropriate diagnostic codes and is able to identify opportunities for improvement from a coding and/or documentation perspective. Must take responsibility for the coding workflow and demands of position.
Physical Demand Level: Sedentary